Magnetic resonance imaging (MRI) of the elbow allows for high-resolution evaluation of osseous and soft-tissue structures, including ligaments, tendons, nerves, and muscles. Multiple imaging techniques and pulse sequences exist. The purpose of this article is to update orthopaedic surgeons on current MRI techniques and illustrate the spectrum of elbow pathology detectable by MRI.

Methods: 

We searched MEDLINE with use of the keywords “MRI” and “elbow” for studies less than five years old evaluating MRI techniques. These papers, our experience, and textbooks reviewing elbow MRI provided the information for this article.

Results: 

We discuss the essentials and applications of the following techniques: (1) conventional, non-gadolinium-enhanced MRI; (2) gadolinium-enhanced MRI; and (3) magnetic resonance arthrography. The classic MRI appearances of occult fractures, loose bodies, ulnar collateral ligament injuries, lateral collateral ligament complex injuries, biceps tendon injuries, triceps tendon injuries, lateral epicondylitis, medial epicondylitis, septic arthritis, osteomyelitis, osteochondritis dissecans, compression neuropathies, synovial disorders, and various soft-tissue masses are reviewed.

Conclusions: 

MRI is a valuable, noninvasive method of elbow evaluation. This article updates orthopaedic surgeons on the various available MRI techniques and facilitates recognition of the MRI appearances of the most commonly seen pathologic elbow conditions.